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Journal of Case Reports
Testicular Infarction Post Inguinal Hernia Repair: Would a laparoscopic approach have helped reduce the risk?
Nishanthinie Parathithasan, Shiran Wijeratne
Mercy Health-Werribee Mercy Hospital, Melbourne; St Vincent’s Health, Melbourne, Australia.
Corresponding Author:
Dr. Nishanthinie Parathithasan
Email: nishanthinie.p@gmail.com   
Received: 12-NOV-2014 Accepted: 31-DEC-2014 Published Online: 20-JAN-2015
DOI: http://dx.doi.org/10.17659/01.2015.0008
Abstract
Testicular infarction is a rare consequence of inguinal hernia repairs. Ischaemic orchitis leading to testicular atrophy occurs in 0.2-1.1% of all inguinal hernia repairs. This case report describes a 52 year old male patient who developed testicular infarction three days post-open inguinal hernia mesh repair. Commonly, ischaemic orchitis is caused by damage to the pampiniform plexus which leads to venous congestion and acute thrombosis. The risk factors for developing testicular ischaemia include large or recurrent hernias. It is thought that open approaches have a higher risk of causing ischaemic orchitis compared to the laparoscopic approach due to the need for greater manipulation of the spermatic cord. However, some studies suggest that both approaches do not reduce testicular perfusion post-operatively. Nevertheless, larger studies need to be conducted to evaluate this further and patients should always be informed about this risk regardless of its rarity.
Keywords : Inguinal Hernia, Ishemia, Testicular Diseases, Orchitis, Spermatic Cord, Humans.
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